Comparison of Repair Integrity and Functional Outcomes for 3 Arthroscopic Suture Bridge Rotator Cuff Repair Techniques

Abstract

Background: No reported study has compared the clinical outcomes of suture bridge techniques. Purpose: To compare the functional outcomes and repair integrity of the arthroscopic single-mattress (SM), double-pulley (DP), and double-mattress (DM) suture bridge (SB) techniques for full-thickness rotator cuff tears. Study Design: Cohort study; Level of evidence, 2. Methods: Seventy-eight consecutive shoulders with full-thickness rotator cuff tears and a 1- to 4-cm anteroposterior dimension underwent arthroscopic SB repairs. The SM-SB technique was used in the first 26 consecutive shoulders, the DP-SB method was used in the second 26 consecutive shoulders, and the DM-SB repair was used in the final 26 consecutive shoulders. Seventy-four shoulders (94.9%) underwent postoperative evaluation for cuff integrity using MRI or ultrasound. Clinical outcomes were evaluated in 76 shoulders (97.4%) at a minimum of 2 years postoperatively. Clinical outcomes were evaluated using the shoulder rating scale of the University of California, Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), and Constant scores at an average of 31 months postoperatively. Results: At final follow-up, the average ASES, UCLA, and Constant scores improved significantly: respective scores were 88.46, 30.58, and 73.96 in the SM-SB group ( P < .001); 87.19, 31.35, and 72.50 in the DP-SB group ( P < .001); and 87.19, 32.81, and 75.35 in the DM-SB group ( P < .001). However, there were no significant differences among the 3 groups in terms of the ASES, UCLA, or Constant scores ( P = .954, .210, and .755, respectively). The retear rate of repaired rotator cuffs was 20% in the SM-SB group, 12.5% in the DP-SB group, and 12% in the DM-SB group; however, the differences among the 3 groups were not statistically significant ( P = .674). The number of suture anchors (mean ± SD) used for repair was 4.31 ± 0.47 in the SM-SB group, 4.00 ± 0.00 in the DP-SB group, and 3.38 ± 0.50 in the DM-SB group ( P < .001). Conclusion: Arthroscopic rotator cuff repair yielded successful functional outcomes without significant differences among the 3 SB techniques. Additionally, no significant differences in repair integrity were observed among the 3 methods postoperatively.